Routine inspection·August 23, 2023

On 8/23/2023 at 12:05PM, Licensing Program Analysts (LPAs) L. Hall and L. Alexander conducted an unannounced 1-Year Required inspection. LPAs met with Levi Villareal, Administrator, and explained the purpose of the visit. The Administrator certificate is pending and expired 3/26/2023. Facility does not have any residents at this time. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area, garage and backyard. The facility consists of four (4) bedrooms and two (2) bathrooms. No bodies of water was observed. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 08/23/2022. First aid kit was observed to be complete. Continued on LIC809. Continued from LIC809. LPA did not review any staff files. LPA requested the following documents to be submitted to CCLD by 8/30/2023. Resident Roster LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan (9 pages) Liability Insurance No deficiencies cited during this visit. Exit interview conducted and a copy of this report provided.